Read the following pages/chapters in your text, Dieting For Dummies this week: Chapter 17-20, pages 201-247

Summary

In Part six you'll get the low-down on the most popular diet books, weight loss medications, weight loss supplements and group programs available. You'll learn which methods are helpful, effective, and safe strategies and which you should abandon. You'll also learn how to determine what a safe and successful weight loss program is on your own, so you'll never spend another penny on weight loss fads and scams again.

Topic outline for Part Six:

Introduction:Obesity is a chronic condition.

Too often, we view it as a temporary problem that we can treat for a few months with a strenuous diet. However, as most successful weight-losers and health professionals know, weight control is a life-long effort. To be safe and effective, any weight-loss program or diet must address the long-term approach, or else the program is largely a waste of money and effort.

Obesity affects about one in four adult Americans, and each year more than half of Americans go on a weight-loss diet or try to maintain their weight. Many people have difficulty in losing just a few pounds, and few succeed in keeping the pounds off permanently. This difficulty losing weight and keeping it off leads many people to turn to a book, medications, or a professional or commercial weight-loss program for help. These avenues are quite popular and are widely advertised in newspapers and on television. However, many of these books and programs fail to demonstrate that they will help you:

1. lose weight,
2. and keep it off,
3. and do it safely.

Let's explore some of today's most popular weight loss methods. Although I could easily write an entire article on each of the programs and methods below, we'll cover each one briefly since so many exist. But, if you want more in-depth information on these programs, books, or medications, be sure to read the “For Further Reading” articles.

The latest popular diet books and fads

1. Low carbohydrate/high protein weight loss plans

Low carbohydrate diet plans that were all the rage in the 70's have resurfaced. However, just like the 70's fashions, some things should be left behind, never to re-emerge. The following diets below vary in the content and type of carbohydrate they restrict, but the restriction of carbohydrate and/or addition of more protein is generally the basis behind all of these diets.

Many of these plans tout irrational theories and fears about the hormone insulin. Insulin, they say, is increased when carbohydrate is eaten, and insulin's role is to store fat. They make the unfounded connection that if you eat carbohydrates, your body stores fat. As an example to this irrational, unfounded theory, Japan has some of the lowest obesity rates in the world. In Japan the diet is overwhelming high in carbohydrates such as rice, grains and vegetables. The bottom line is that insulin does not store any calories as fat if you burn off more calories than you eat in a day. The source of the calories you eat, whether protein, carbohydrate, or fat, does not matter when it comes to weight loss. If, however, you eat more calories than your body burns off, then insulin does play a role in transporting those calories to your fat cells.

Study after study shows that calories, not the composition of carbohydrates, protein, or fat in your diet, are what matters when it comes to weight gain. Furthermore, many of the authors below, including Dr. Atkins and Barry Sears, have never published a single controlled study to substantiate the claims they make in their books. They will often cite testimonials with their client's success, but this is not credible research or evidence. Credible research is conducted by an independent organization (not by the person who has a vested interest in the outcome of the research) and is published in a reputable medical journal. Prior to being published, the research is peer-reviewed for reliability, accuracy and potential flaws by other physicians and scientists. Client testimonials cited by the authors are not valid research.

You will usually lose weight on these diets, but that's typically because you significantly restrict calories when you take away carbohydrates. Think about all the foods you can no longer eat when you restrict carbohydrate. It's essentially a caloric restriction, not a magic weight loss diet. More importantly, very few people are able to maintain their weight loss with these plans as they eventually become too difficult to follow permanently. Low-carb diets have been around for decades, yet there are no published studies that document their long-term success at keeping weight off. If they were successful in the long-term, the re-release of these books and programs wouldn't even be necessary, and we would not see continued skyrocketing obesity rates despite millions of low-carb diet plan book sales.

Many of the authors go on to claim that low-fat, high-carbohydrate diets are the reason for emerging obesity rates in America. But, the authors fail to provide this data from the National Center for Health Statistics:

1. Fat intake has barely budged from 81.4 grams a day to only 82 grams per day. It has not decreased.
2. We eat on average 100 to 300 more calories a day over the years.
3. We exercise less.

Basically, caloric intake has increased and physical activity has decreased. That is the bottom line behind soaring obesity rates.

A final argument against these diets is that many call for significant restrictions in foods we know to be healthy such as fruits, starchy vegetables, and whole grains. Study after study shows that plant foods, such as whole grains, fruits and vegetables contain hundreds, if not thousands of components that may help to prevent numerous diseases. In fact, one of the best ways to reduce cancer risk is by consuming a minimum of 5 fruit and vegetable servings daily -- virtually impossible on a very low carbohydrate plan. Eliminating these foods might increase your chances of many chronic diseases down the road. By contrast, little to no studies tout the benefits of extra saturated fat in the diet, or the health benefits of high intake of meats and proteins. Scientifically and health-wise, these diets make no sense.

The most popular low carbohydrates/high protein plans

• Dr. Atkins New Diet Revolution - This diet, as well as Protein Power, calls for the most significant carbohydrate restriction of the diets listed here. Eliminating or significantly reducing so many foods - fruits, grains, sweets, starches, cereals, pasta, sodas, snacks, pancakes, pies, cakes, cookies, breads, flours, potatoes, etc. - is the real key behind the weight loss. Can you eliminate or severely restrict all these foods forever? In the real world?

• Protein Power - Similar to the Atkins diet, this diet relies on the process of ketosis to help you shed pounds. Ketosis happens when you don't eat enough carbohydrates, which are your body's primary fuel source. First, your body first burns its carbohydrate stores, then the protein in its lean muscle tissue for energy. This process causes the release a lot of stored water weight. In the first weeks of these diets, the pounds drop off - but it is due to the excretion of all this water, not fat. Remember too, that your goal is to maintain as much muscle mass as you can to keep your metabolic rate elevated - you don't want your body burning your muscle for energy, which happens in ketosis. Eventually, your body also starts burning some fat, but not as well as exercise or slight caloric restriction does. And weight loss stops when you add more carbohydrate back to your diet. So, if you ever plan to eat normally again (and if you're human, you will want to), count on the lost weight returning (note: weight gain after re-adding carbohydrates is due to water storage, not FAT gain).
• The Carbohydrate Addict's Lifespan Program - The authors believe that you can eliminate carbohydrate cravings by limiting the amount of carbohydrate you eat and only eating carbohydrate at certain meals. That's like telling an alcoholic to only drink at certain times of the day as the answer to his addiction. We already learned about our brain's biochemistry. To deal with carbohydrate cravings, you probably have more to deal with the things that lead to cravings in the first place. Stress reduction, dealing with emotions, and exercise can raise those serotonin and endorphin levels and combat cravings. Manipulating the foods you eat might help, but it's not the full answer for eliminating cravings, and certainly eating carbohydrates only at one meal is not the answer (as this plan recommends). You need to begin at square one.
• Sugar Busters! - This book asserts that any food that leads to insulin surges causes insulin to store those calories as fat. This diet limits sugars and some starchy carbohydrates due to this mistaken theory. Again, nothing gets stored as fat unless you eat more calories than your body burns. While it's a good idea to limit sugars and foods that provide few good nutrients, this book irresponsibly assigns too much blame on insulin as the cause of obesity. Also, most foods are eaten in combination, not by themselves, which significantly alters insulin's response. For example, eating a plain baked potato will have a significantly different glycemic response than having a baked potato with sour cream or even a baked potato with steak at the same meal.
• The Zone - The author claims that by following a diet composed of exactly 30% protein, 30% fat and 40% carbohydrate at each meal or snack, you will be put into a fat burning "zone." No studies support this claim nor has Dr. Sears ever published a diet-related study. However, you'll probably lose weight on this diet because the menus average only 1200-1700 calories a day - the real reason behind the weight loss. How easy is it to follow exact menus of 40/30/30 for the rest of your life? That is a full-time job even for a registered dietitian!

2. Food specific diets

• Eat Right 4 Your Type - The premise of this book is that you should eat only certain types of foods based on your blood type and ancestry. For example, if you're a type A, you have ancestors who were farmers, and you should be a vegetarian and avoid most animal products and meats. By contrast, if you're a type O, then your ancestors were likely hunters and gatherers, and you should eat lots of animal proteins and meats, but few carbohydrates. The claims are ridiculously unsubstantiated and not backed by any research.

• The New Beverly Hills Diet - This book says that if you don't combine foods carefully, you gain weight. On the first two days of the diet, only certain fruits and vegetables are allowed; on the 3rd day only grapes - that's right, you eat only grapes for a whole day. The book goes further to state that one should never combine fats, proteins, or carbohydrates, or your digestive enzymes become confused. Thus, not only is the food not digested properly, but also, you'll store fat. Imagine that. You will lose weight on this diet, but only because of the extremely low number of calories. No science whatsoever is behind any of its claims about food combining, digestion, or storage of fat.
• The New Cabbage Soup Diet - You can eat as much cabbage soup, fruit, coffee, caffeine, and tea as you want on this diet, but not much else. Can you say, "extremely low calorie diet that promotes rapid fluid loss and burning of valued muscle tissue to lose weight quickly"? That's what this plan offers.

For a further comparison of these type of diets/fad-diets see the following article from TheDiet Channel: Popular Diets versus Dietary Guidelines.

3. Low-fat diets laden with high sugar, fat-free products

Just like the stock market, diets come and go in big waves. Not too long ago, extremely low-fat diets were all the rage and everyone was counting fat grams. Mistaken beliefs about weight loss arose from these types of diets as well. Many people thought that only fat in the diet could be stored as fat - wrong. All calories eaten in excess can be stored as fat. Many figured as long as the ice cream was fat-free, the calories did not matter - wrong again. Food manufacturers produced fat-free products in hoards, and people bought them right up. It's important to realize that fat-free does not necessarily equal healthy and good for you. Many of these products contain excessive amounts of sugar to replace the fat. Often, they contain a very similar amount of calories as the regular high-fat products. Our fat eating guidelines:

• Choose a well-balanced diet moderately low in fat and saturated fat (less than 30% of calories and 10% of calories respectively)

• Don't eat excessive amounts of processed fat-free products (cookies, ice cream, potato chips and the like)
• Choose mostly unsaturated fats such as olive oil, canola oil, peanut butter, and nuts.

In short, with regard to all the plans above: don't follow a crazy, restrictive, unbalanced, expensive or unhealthy plan to lose weight. A mild caloric deficit, combined with exercise and behavior modification, is your biggest guarantee at losing weight, keeping it off, and doing it safely. And that, my friend, is backed by hundreds of controlled research studies and hundreds of thousands of long-term success stories, unlike the plans above.

For further information on the fats you should include in your healthy eating diet see the following article from TheDietChannel: Healthy and Fat? 5 High-Fat Foods You Should Not Avoid.

The picks of the crop: the best books on diet and weight loss

Perhaps now you'd like to know what are some of the best books on the subject of diet and weight loss, which share the following common traits:

• Sound independent research supports the claims

• A well-balanced diet, that is not too restrictive or difficult to follow, is advocated
• Exercise is an important part of the plan, and not just mentioned briefly in passing
• The foundation of the book in many cases advocates a behavioral approach to weight loss
• The plan makes no magical claims of easy weight loss. However, the strategies the book promotes are the most time-tested ones that lead to permanent losses and lifelong changes.
• The plans are safe to follow

The Best Diet Books:

• The Diet Free Solution, by Laurel Mellin, M.A., R.D.

• Thin For Life, by Anne Fletcher, M.S., R.D.
• Intuitive Eating: A Recovery Book For the Chronic Dieter, by Evelyn Tribole, M.S., R.D.
• Outsmarting The Female Fat Cell, by Debra Waterhouse, M.P.H., R.D.
• Strong Women Stay Slim, by Miriam Nelson, Ph.D.
• The Origin Diet, by Elizabeth Somer, M.A., R.D.
• Dieting For Dummies, by Jane Kirby, R.D.
• Make The Connection, by Oprah Winfrey and Bob Greene
• Breaking Free From Compulsive Eating – by Geneen Roth – or any other book by this author

Group Weight Loss Programs

• Weight Watchers - This program is a personal favorite of mine because Weight Watchers never resorts to fads or scams to sell its product. Even in the height of the low-carbohydrate diet craze, which is selling like mad, Weight Watchers continues to advocate a sensible, long-term approach to weight loss. The basis of the program is a reduced-calorie diet (with no restriction of the types of foods you are allowed to eat), exercise, and behavior modification. The program also includes group counseling sessions and group support - two aspects that can be vital in maintaining lost weight. Clinical psychologists, exercise physiologists, and registered dietitians developed the Weight Watchers program. It maintains a very integrated approach to losing weight.

• Jenny Craig - Jenny Craig is similar to Weight Watchers in that it offers a reduced-calorie diet, exercise, and behavior modification as the basis of the program. In addition, an integrated team of weight loss professionals developed the program. The drawback is that initially you must purchase only prepackaged Jenny Craig foods as your main meals. This leads to less awareness of how to eat and shop on your own, and a higher program cost than Weight Watchers.
• Overeaters Anonymous - OA is not a weight loss program per se, but rather, a volunteer support group for those who admit to their inability to control their eating. OA is a 12- step program similar to Alcoholics Anonymous. It can be a great program if you truly feel you cannot manage food binges, and that food has taken over your life. No health care providers are on the staff. The support of the group and the seeking of a higher power and spiritual values and learning life skills are the mainstays of the program. Many have found OA to be the real answer to combating their food addictions.
• TOPS (Taking Off Pounds Sensibly) TOPS is not a weight loss plan, but rather a non-profit, non-commercial weight loss support group. You bring your own diet and exercise plan and goals, and TOPS provides the environment to exchange ideas and support with others trying to lose weight. A volunteer leader runs local chapters, and health professionals often speak at the meetings.
• The Solution - The solution is a group program, developed by Laurel Mellin, RD, an associate clinical professor of family and community medicine at UC San Francisco. Its main focus is not on a diet, but rather on healthy living, exercise, emotional healing, behavior modification, and nurturing the mind, body, and spirit. Mellin published a study in The Journal of the American Dietetic Association showing significant long-term weight loss success for those in her program. If you're a chronic overeater, or often eat when you are not hungry, a behavioral approach (rather than a diet approach) to weight loss is your best bet. The Solution is offered nationwide and is conducted by trained leaders.

How to evaluate diet plans

Almost any commercial weight-loss diet can work, but only if it motivates you sufficiently to decrease the amount of calories you eat or increase the amount of calories you burn each day or both. Regardless of whether a diet plan works for you initially (a few weeks or a few months), you must ask yourself whether it can work forever. Which elements of a weight-loss program should an intelligent consumer look for in judging its potential for safe and successful weight loss?

A responsible and safe weight-loss program should have the following features:

1. The diet should be safe

It should include the Recommended Daily Allowances (RDA's) for vitamins, minerals, and protein. The weight-loss diet should reduce only calories, not essential foods and food groups. You should not have to buy supplements in order to meet your RDA. If the diet itself can't provide the RDA because it eliminates too many foods or food groups, the diet is unsafe.

2. A slow, steady approach is the best weight loss

The weight-loss program should work towards a slow, steady weight loss. Expect to lose only about a pound a week after the first week or two. With many calorie-restricted diets, you can initially lose weight rapidly during the first 1 to 2 weeks, but this loss is largely fluid.

3. For certain conditions the program should recommend a doctor's evaluation

If you plan to lose more than 15 to 20 pounds, have any health problems, or take medication on a regular basis, the program should recommend a physician's evaluation before you begin. A doctor can assess your general health and medical conditions that dieting and weight loss might affect. Also, a physician should be able to advise you on the need for weight loss, the appropriateness of the weight-loss program, and a sensible weight loss goal for you.

4. Weight maintenance should be included in the weight loss program

The program should include plans for weight maintenance after the weight loss phase ends. You don't want to lose a large amount of weight only to regain it. Weight maintenance can be the most difficult part of controlling weight. Select a program that helps in permanently changing your dietary habits and level of physical activity and alters a lifestyle that might have contributed to weight gain in the past. Your program should provide behavior modification help, including education in healthy eating habits and long-term plans to deal with your emotional and behavioral issues that lead to weight gain.

5. All fees and costs should be clearly identified for commercial weight loss programs

A commercial weight-loss program should provide a detailed statement of fees and costs of additional items such as dietary supplements. You shouldn't need to purchase a dietary supplement to lose weight successfully. If a program asks you to buy herbs, vitamins, minerals, or other supplements, you should thoroughly screen them before such a purchase. Ask your doctor or a registered dietitian at your local hospital about the need for such products, especially if they involve a large cost.

6. A good weight loss program will use several experts' credentials

Have a good grasp on the credentials of those selling the program, the products, or the books. A truly successful weight loss program has a very integrated approach using several experts. It might have a physician to supervise the overall program, an exercise physiologist to counsel you on exercise, a psychologist or licensed counselor to discuss behavioral issues, and a registered dietitian to discuss nutrition and eating habits. Be aware that no legal definition exists for the term "nutritionist." Anyone can legally call himself or herself a nutritionist. A registered dietitian is a legal term, however, and he or she must obtain a minimum of a bachelor's degree in clinical nutrition or a related field, complete 900 hours of internship experience and pass a national exam, and most go on to pursue graduate degrees. The sales clerk in the nutritional supplements store is not usually a good source of nutrition advice! This is an area where all too many people claim to be experts. Check your sources of nutrition and weight loss advice carefully.

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